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Top X of Australian and New Zealand Glaucoma Club Annual Scientific Meeting

February 23-24, 2001

Anne Brooks

• Erik Greve: "The image of glaucoma" predicts that "optic nerve fibrometry" is a dream and that the currently available imaging technology is best for recording the present state and for intrapatient comparison because of the overlap in normals; it is of use to detect earl change in susceptible individuals. The effect of intraocular pressure is a major difficulty with current measurements.   

• In the management of glaucoma and cataract, if there is no indication for trabeculectomy and a cataract is present then cataract surgery alone is indicated, with trabeculectomy if necessary later. If there is a good indication for trabeculectomy and some cataract is present then combined surgery is indicated. Cataract extraction will open the angle more widely.   

• In normal pressure glaucoma, the absolute value of the intraocular pressure is no to value, it is a "faute de mieux". It was noted that myopic discs are the most progressive and progress at an early stage to the central area.

• Stuart Graham reported that with multifocal objective perimetry using the ObjectiVision^TM System, electroencephalographic (EEG) scaling of the visual evoked potential reduces interpatient variability. Using the power of the EEG response, the VEP is scaled up or down.   

• Mike Patella reported on standard automated perimetry with the Zeiss Humphrey perimeter. A change probability map based on pattern deviation will be available for SITA standard and SITA fast in the next 12 months.   

• Tony Molteno's group reported that in 7 eyes of 4 infants with buphthalmos and congenital glaucoma drained with a Molteno implant, there was a return to emmetropisation as well as long term control of their glaucoma. 

• Anne Brooks reported that in chronic angle closure glaucoma, iridectomy checked the progression of peripheral anterior synechiae in the affected eye and no fellow eye progressed after peripheral iridectomy.   

• Gary Smith from Alcon reviewed Azopt (Brinzolamide 1%) the topical carbonic anhydrase inhibitor which has just become available in Australia. The twice daily dosage and reduction in symptoms of stinging compared with Dorzolamide were noted.

• Philip House reported that deep sclerectomy was of no value, with inadequate lowering of intraocular pressure unless perforation occurs which converts the procedure to a trabeculectomy.    

• Ivan Goldberg reported on Hettinger scores and change in visual field sensitivity before and after a hand vibration stimulus in patients with vasospastic tendencies. He found that betaxolol suspension 0.25% bd was associated with a significantly smaller reduction in arcuate visual field sensitivity and a higher mean sensitivity in the arcuate visual fields than timolol 0.5% bd in these subjects.